Handful of Palomar Pomerado nurses say they need more help

POWAY -- Five intensive-care and emergency-room nurses angrily
criticized Palomar Pomerado Health board members and administrators
Monday night for spending $255,000 last month on marketing measures
and a nurse-recruiting consultant.

The district's nursing staff, the five said, has too many
patients to safely care for. The district could have better spent
the money, they said, by "buying equipment that works," putting
more nurses on shifts at Palomar Medical Center and Pomerado
Hospital, and increasing the numbers of support staff -- certified
nurse aides -- that nurses rely upon.

"I've seen registered nurses' patient loads increase by up to 25
percent during the last six months," said Susan McGuire, an
intensive-care nurse at Palomar Medical Center for the last six
years. "In critical care, our support staff has been reduced, and
RNs spend more time being secretaries, transportation aides and
equipment trouble-shooters, and less time being RNs all the
time."

Several board members lauded the nurses for coming forward
Monday night, but defended their own actions, saying they are doing
their best to try to deal with a national nursing shortage at the
same time the district is struggling to stop losing money.

Palomar Pomerado Health posted $27 million in losses in the
fiscal year that ended in June, but recently posted its first
monthly profits in nearly 1 1/2 years in February and March.

Last month, district officials said their nursing vacancies had
increased from 108 in January to 148. At full staff, the district
would employ 615 nurses at its two hospitals.

In April, in the hope of increasing business and revenue, board
members approved spending $75,000 to change the district's name
from Palomar Pomerado Health System to Palomar Pomerado Health, and
to design a new logo for the district. At the same time, the board
approved spending $180,000 on a national consulting firm, H*Works,
that promises to attract more nurses to the district and find ways
to keep the ones already employed.

The five nurses who came forward Monday said the district is too
concerned with finances, and is not paying attention to the quality
of patient care.

In the most emotional address Monday night, Sandra Dewees, who
has been an emergency-room nurse at Palomar Medical Center, told
the board she was quitting the emergency room because she was
becoming increasingly worried about the welfare of her
patients.

In particular, Dewees noted an incident last week where a
"crazed" patient stole an ambulance. Dewees intimated it happened
in part because there were not enough nurses on hand to pay
attention to all the patients.

"I turned in my beeper. I'm done," Dewees said. "I'm ashamed of
the care I have to provide in the emergency room."

McGuire said nurses were offended by the board's decision to
hire H*Works to interview the district's staff to find ways to
reduce the district's 25.6 percent nurse turnover rate.

McGuire said Palomar Pomerado nurses have been outspoken,
telling administrators what they need to do their job -- but the
message has fallen on deaf ears.

McGuire said nurses need more help so each nurse has fewer
patients to care for, higher salaries, and "enough medical
equipment so that we don't have to go searching all over the
hospital -- leaving our patients."

McGuire said some nurses have discussed unionization.

After the meeting, Lori Burnell, the chief nurse executive at
Pomerado Hospital, said she understood the passion exhibited by the
nurses at Monday's meeting, but said that their story was
one-sided.

The district, Burnell said, has tried its best to hire more
nurses, and has relied on expensive private nursing companies to
fill the gap.

"All I can tell you is Lorie Shoemaker (chief nurse executive at
Palomar Medical Center) and I are 200 percent dedicated to turning
this situation around … it would be good for us to work together
instead of apart."

Norm Gruber, the hospital district's chief executive officer,
said he empathized with the nurses, but added that the district was
trying to fix its nursing shortage.

"With respect to things like salaries and benefits, you know, we
gave our nurses an across-the-board 6 percent raise last September,
and we continue to keep track of what our competitors do in that
area. So far, our information shows we're competitive," Gruber
said.